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目的探讨中国人群肥胖与食管癌发病风险的关系,评估BMI与食管癌发病风险的剂量反应关系。方法系统性检索国内外公开发表的有关中国人群BMI与食管癌发病关系的中英文文献,并辅以文献追溯等方法,检索数据库包括中国知网、万方数据知识服务平台、Pub Med、Embase和Google Scholar,时间范围从各数据库建库至2014年9月,共检索到60篇文献。采用Meta分析方法计算肥胖与食管癌发病风险的合并OR值(95%CI),运用最小二乘估计方法(GLST)估计BMI与食管癌发病风险的剂量反应关系。结果最终纳入文献5篇,纳入食管癌病例7 215例。Meta分析结果表明,肥胖与中国人群食管癌发病风险呈负相关(OR=0.56,95%CI:0.35~0.90),并且这种负相关不受研究类型、地区、BMI获取方式和病例来源的影响。BMI与食管癌发病风险呈线性剂量反应关系,BMI每增加5 kg/m2食管癌发病风险降低(OR=0.57,95%CI:0.54~0.60)。结论本次Meta分析结果显示高BMI是中国人群食管癌发病的一个保护性因素。
Objective To investigate the relationship between obesity and the risk of esophageal cancer in Chinese population and to evaluate the dose-response relationship between BMI and the risk of esophageal cancer. Methods Chinese and English literatures about the relationship between BMI and esophageal cancer in Chinese population were systematically searched and published in domestic and abroad, supplemented by literature review and other methods. The retrieval database included CNKI, Wanfang Data Knowledge Service Platform, Pub Med, Embase and Google Scholar, from the database to September 2014, a total of 60 articles were retrieved. Meta-analysis was used to calculate the combined odds ratio (95% CI) of the risk of obesity and esophageal cancer. The least squares estimate (GLST) was used to estimate the dose-response relationship between BMI and the risk of esophageal cancer. Results were finally included in the literature 5 articles, including 215 cases of esophageal cancer cases. Meta-analysis showed that obesity was negatively correlated with the risk of esophageal cancer in Chinese population (OR = 0.56, 95% CI: 0.35-0.90), and this negative correlation was not affected by the type of study, the region, the pattern of BMI acquisition, and the source of the disease . There was a linear dose-response relationship between BMI and the risk of esophageal cancer. The risk of esophageal cancer was lower for every 5 kg / m2 increase in BMI (OR = 0.57, 95% CI: 0.54-0.60). Conclusions This meta-analysis shows that high BMI is a protective factor in the pathogenesis of esophageal cancer in Chinese population.